title: Endovascular technique using a snare and suture for retrieving a migrated peripherally inserted central catheter in the left pulmonary artery.
abstract: We report a successful endovascular technique using a snare with a suture for retrieving a migrated broken peripherally inserted central catheter (PICC) in a chemotherapy patient. A 62-year-old male received monthly chemotherapy through a central venous port implanted into his right subclavian area. The patient completed chemotherapy without complications 1 mo ago; however, he experienced pain in the right subclavian area during his last chemotherapy session. Computed tomography on that day showed migration of a broken PICC in his left pulmonary artery, for which the patient was admitted to our hospital. We attempted to retrieve the ectopic PICC through the right jugular vein using a gooseneck snare, but were unsuccessful because the catheter was lodged in the pulmonary artery wall. Therefore, a second attempt was made through the right femoral vein using a snare with triple loops, but we could not grasp the migrated PICC. Finally, a string was tied to the top of the snare, allowing us to curve the snare toward the pulmonary artery by pulling the string. Finally, the catheter body was grasped and retrieved. The endovascular suture technique is occasionally extremely useful and should be considered by interventional cardiologists for retrieving migrated catheters.
authors.affiliation: Hiroki Teragawa, Takashi Sueda, Yuichi Fujii, Hiroaki Takemoto, Yasushi Toyota, Shuichi Nomura, Department of Cardiovascular Medicine, Hiroshima General Hospital of West Japan Railway Company, Hiroshima 732-0057, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Teragawa
authors.forename: Takashi
authors.initials: T
authors.lastname: Sueda
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Fujii
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takemoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Toyota
authors.forename: Shuichi
authors.initials: S
authors.lastname: Nomura
authors.forename: Keigo
authors.initials: K
authors.lastname: Nakagawa
keywords: Catheter migration; Endovascular suture technique; Port catheter